Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD.026638 | LA |
NPI | 1013083112 |
---|---|
Provider Name | Socrates Zapata-Campusano |
First Address | Hammond, LA 70404-3087 |
Second Address | Hammond, LA 70403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 19/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1489204 | (05) | LA |